표재성 방광암에서 Photodynamic Diagnosis (PDD)를 이용하여 조기 유전학적 변화를 예측할 수 있는가? |
김대경1, 홍정희, 최한용 |
1을지대학교 의과대학 비뇨기과학교실, 성균관대학교 의과대학 비뇨기과학교실 |
Can Photodynamic Diagnosis in Superficial Bladder Tumor Predict Early Genetic Changes? |
Dae Kyung Kim1 , Jeong Hee Hong , Han Yong Choi |
1Department of Urology, Eulji University College of Medicine, Daejeon and Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea |
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Abstract |
" Purpose: Photodynamic diagnosis (PDD) is a newly developed diagnostic tool for detecting cancerous and/or pre-cancerous lesions in various tumors such as GI, skin and bladder malignancy. In this study, we evaluated the usefulness of PDD in detecting the early change of carcinogenesis in superficial bladder tumor. Materials and Methods: We examined the 19 bladder tissues (14 PDD positive tissues and 5 PDD negative tissues) from 9 superficial bladder tumor patients after PDD-assisted transurethral resection of the bladder tumor. In all specimens, routine H-E staining was done for pathologic diagnosis and in-situ hybridization (ISH) using an alpha satellite probe for chromosome 9 centromeric region (D9Z1, Oncor.) was done for detection of chromosome 9 deletion which is one of the most common chromosomal changes in superficial bladder tumor and regarded as an early event in carcinogenesis in superficial bladder tumor Results: Of the fourteen PDD (+) tissues, nine cases were bladder tumors, three cases were chronic inflammations and two cases were urothelial hyperplasias with H-E staining. Chromosome 9 deletions were observed in eight of nine bladder tumor tissues (89%) and in three of five non-tumorous tissues (60%). With PDD, therefore, we could find the three pre-cancerous lesions in which no evidences of malignancy were found microscopically. Of the five PDD (-) tissues, three cases were chronic inflammations and two cases were normal. There was no chromosome 9 deletion in all cases of PDD (-). Conclusions: With PDD, early detection of pre-cancerous lesions in the bladder is possible. PDD might be helpful in complete resection of the flat urothelial lesions including the pre-cancerous tissues and decrease the recurrence and progression rates of the superficial bladder cancer." |
Key Words:
Bladder tumor, Photodynamic diagnosis, Chromosome 9 deletion |
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